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頁籤選單縮合
題名 | Periventricular leukomalacia in infancy:Ultrasonic diagnosis and neurological outcome=嬰兒期腦室周圍白質軟化: 超音波診斷及預後 |
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作者 | 廖璽璸; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 31:5 民79.09-10 |
頁次 | 頁288-298 |
分類號 | 417.509 |
關鍵詞 | 白質; 周圍; 軟化; 診斷; 超音波; 腦室; 預後; 嬰兒期; |
語文 | 英文(English) |
中文摘要 | 自1984年到1989年6月間,馬偕醫院小兒科有24例病人經顱部超音波診斷爲囊性週腦室白質軟化症。這24例病人分爲兩組;A組共有6例,乃爲新生兒加護病房經一連串超音波掃描可見囊性週腦室白質軟化症各期變化者。2例爲男嬰,除1例足月外,其餘5例爲早産兒,均有嚴重的週産期問題。在出生後2~7天內可於超音波影像見到腦室周圍呈高回音區;在18到60天大時見到腦室周圍囊腫形成及腦室擴大的現象。其中1例失去追蹤,另1例在右額葉有單一小囊腫發育正常,其餘四例均爲腦性麻痺兒。B組的18例病嬰均爲心智動作遲緩而到總論求診,其中11例在超音波或電腦斷層的檢查上可見囊性週腦室白質軟化的特徵,而另外7例因週腦室囊腫並不明確,雖有腦室擴大及不規則腦室壁,僅列爲疑似週腦室白質軟化病例。全部的病例均爲腦性麻痺兒,其中12例爲痙攣性四肢癱瘓,3例爲下肢癱瘓,2例爲半身偏癱,1例爲低張腦性痳痺。因爲週腦室白質軟化與日後神經方面後遺症具相當關連性,在新生兒加護醫學日漸發達的今日,若能早期以腦部超音波偵測,並作密切的追蹤,一旦確定形成囊性週腦室白質軟化後,且須每1~2個月作腦神經學檢查,以期早期發現與治療神經方面後遣症。 |
英文摘要 | During the more than five years from January 1984 to June 1989, twenty-four patients with definite or probable cystic periventricular leukomalacia (PVL) were diagnosed by cranial ultrasonography at Mackay Memorial Hospital. The 24 patients were divided into two groups. Group A comprise two boys and four girls who received longitudinal sonographic follow-ups for leukomalacia. Of these six patients, five were premature and all suffered from severe perinatal insults. In each case, sequences of developmental cystic PVL were observed by serially scanning the brain. High echogenecity was discovered during the initial stages (2 to 7 days) in the pen ventricular area and cystic formations were observed between the age of 18 and 60 days. Clinically, only one patient developed normally; four had severe motor dysfunction and poor motor development; and one was lost during follow-up, Group B was composed of 18 patients who visited the out patient clinic for psychomotor retardation evaluation, and were found through ultrasound to have or possibly have cystic PVL formations at various stages. The clinical work-up revealed that 12 had spastic quadriplegia; 2 had hemiplegia; 3 had spastic displegia; and 1 case had hypotonic cerebral palsy. In infants, PVL is considered to be a much more reliable and important prognostic predictor than intraventricular hemorrhage. Consequently, it is crucial that physicians should screen patients at high risk for PVL, especially those with perinatal insults. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。